HomeMy WebLinkAbout16-17160 , � CITY OF ZEPHYRHILLS
5335-8TH STREET -
(813)780-0020 17��6�0
BUILDING PERMIT '�
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PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17160 Address: 37812 ALISSA DR BLDG 11 UNIT A
Permit Type: MECHANICAL ZEPHYRHILLS, FL.
Class of Work: A/C CHANGEOUT Township: Range: Book:
Proposed Use: NOT APPLICABLE - Lot(s): Block: Section:
Square Feet: ' Subdivision: ORANGE BLOSSOM RANCH
Est. Value: Parcel Number: 15-26-21-0170-01100-OOAO
Improv. Cost: 4,211.04 OWNER INFORMATION
Date Issued: 3/14/2016 Name: MOSKOVICH-HAINES NANCY
Total Fees: 60.00 Address: 37812 ALISSA DR
Amount Paid: 60.00 ZEPHYRHILLS FL 33542-5630
Date Paid: 3/14/2016 Phone: 813-997-4543
Work Desc: A/C CHANGE OUT 2 TON SPLIT SYSTEM
CONTRACTOR S APPLICATION FEES
CHRIS' A/C CO. A/C CHANGEOUT 60.00
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Ins ections Re uired
DUCTS STALLED
DUCTSINSU ED
FINAL � •- ��-
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your properly. If you intend to obtain financing,consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans,Specifications Must Accompany Application.All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
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CONTRACTOR SIGNAT E PERMIT OFFI R
PERMIT EXPI ES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City af Zephyrhills Permit Application Fax 813-780.0021
� 8u1lding Qepartment
Qate Recelved ' Phone Contact for AermlttFn r� � � — ! � �
Qwne�'s Name 6C i'1 • Owner Phane Number !J�� ' t r r'�'�,.�'��
Owner`s Address �� /�5,,�'�-- � //l� Owner Phone Number �� �
Fee Slmple Titleholder Name � � Owner Phane Number r� �
Fee Simple Tftleholder Address
JOB AQDRESS � I p` //SS a— /!�' LOT# �
SUBDMSION � � PAFtCEL ID# /� •o� • ' �(� • G? � </�
(OBTAINED FROM PROPERTYTAX NOTICE)
WORK PRBPOSED NEW CONSTR ADDtALT � S1GN Q Q E}EMO�ISH
e INSTALL REPAIR
PRQPOSED USE Q SFR Q COMM � OTNER
TYPE OF CONSTRUCTION Q BLOCK " Q FRAME � STEEL Q
DESCRIPTION OF WQRK (/ C �ic'! .�C�ti1" � �
BUtIDING SIZE �� � SQ FOOTAGE[�__� HEIGHT �'Ui�
�����'�1��' �.� � VALUATION OF TOTAL.CONSTRUC710N
QELECTRICAl. � � AMP SERilICE Q PROGRESS ENERGY Q W.R.E.C.
, QPLUMBtNC7 ��
[,V�MECHANICAI $ VAlUAT10N OF NiECHANICAI.INSTAL�ATiON
, J .
�c�s [� ROOFING p sP�ci,a�.rr 0 t?THEE2
FINISHED FLOOR ELEVATIQNS ��� FLOOD ZONE AREA QYES NO
_ BUILDER __ GONlPAHY
SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N
Address License# � �
ELECi'RtCtAN! COMPAMf
SIGNATURE '' REGIS7ERED Y/ N FEE CURRE� Y/N
Address License# �! ^��
PLUMBER � CO[VIPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
,,, „_,,,,
Address _^ License# �— �
MECN�4NiCAL � , �, COMPANY fZ/`!S �
SIGNATURE �rr REGISTERED / N EE CURRE� /N
Address- GJ �} ` License# �� S�
' OTHER COliI1PANY
SIGNATURE REGIS'TERED Y/ N FEE CURRE� Y/N
Actdress License# �_ ��
RESIDENTIAt. Attach{2}P1at Plans;(2}se#s af Bitilding'Plans;{1}set of Energy Forms;R-O-W Permit for new ccnsWa6an,
� Minimum ten(10)working:days.after.submittal da1e. Requlred onsite,Constructian Pians;Stormwater Pla�s w/Sllt Fence installed,
- Sanitary Faciqties.&;1:dumpster,Site Work•Permit for subdlvislonsAarge projects �
COlNMERC1At. Attach{3}complete sefs of Buildirig Plans plos a l.ife Safety Page;{1)set af Energy Forms.R-O W Permit for s►ew constnsctian.
Minimum#en(10)working days'after submittal date. Required onsite,CansUucUan Plans,Stormwater Plans w/Silt Fenae installed,
Sanitary Fmcilitias&1 dumpster.Site Work Permit tor all new proJects.All commercial requlrements must meet compltance
S1GN PERMIT Attach{2)sets af�ngtneered Plans.
""PROPERTY SURVEY required for all NEW constructlon.
Otrectlons:
FIII out applicatlon completely.
Owner&Guntractor slgn back of appltcation,nota�ized
If aver 52504,a Natice of Commencemes�t[s required. (AIC upgrades over�7540)
�I '" Agent(fpr the contractor)or Power of Attamey(far the owner)would be someone with notarized letter from owner authorizing same
� DVER THE COUNi'ER PERMIiTiNG•:-:• �u{Fron#ofApplicatian-{}nly}.,:.�
Reroofs if shingles Sewers ' Service.Upgrades�.d/C �''°� Fences(PIoUSurvey/Footage)
Driveways-iVat aver Counter if dn ptiblic madwayrs..needs°ROW' �
OVOTICE�F�EED RfES'�'R1�Y�AN�: �'he ur�der�lgned undet�tands Ehat thl�.pe�mit.r�ay.be,subjeat to"deed"restrlcttons"
which may be;more'resttictive than County regulatlons. �The undersigned assuiries responsibility for compflance with any
appUcabie deed restricti�ns, . �
UN�ICENSED CONTRACTORS ANt� C�NTRACTOR RESPONSI�IEITt��: If the owner has hired a contractor or
contractors ta undert�ke work, #hey may be:required to be licensed in accmrda,nee.with state.and•Iocal r�gulations. If the
contractor 1� not licens�d as requlred`by law, both the �wner and contractor may be alted far a misdemeanor vlolation
under skate law. If the owner or fntended cantractar are uncertaln as to what Itcensing.requirements 'Pnay apply�or khe
intended u�ork, they are aduiser!to con#act the Pasco County Build4ng lnspectlon Dlvlslon--LtcensEng Seckbn at 7�7-84?-
800g. Furthermore, if the awner has hired a cont�acfor or aontractors, he is advlsed to have the contractor(s) sign
portions of the "contractor Block" of Qhis appllcation for which they wlll be responsible. If you, as_the owner"sign as the
contractor, that may be an indEaation that-1ie Is nat.properly Ilcensed and Is not entttled to pe�mit#Ic�g p�ivileges In Pascv
County.
TRANSPQRTATION IMPACTI!!i'IUTlES lMPACT'�1ND-RES�URCE�EC01fERY�fEES: The underslgned understands
that Transportatioe� Innpaef Fees and.R�eeaurse Recmve.ry.Fees may_apply ta°the canstruction of new buildings, change of
use in existing buildings, or,expansion�of�existirig�6uildings, as specffled in pasco County Ordinance number 89-07 and
90-07, as amend�d.. The underslgned also understands, fhat such fees,-_as�anay be�due;.wt11.6e identified at the'time of
perr�it#ing. It is further understood that Transportatlon Impact Fees and`Resource Recovery'Fees must be paid prior to
recelving a "ce�tificate of occupancy" or finai power. release. =1f�the projeat tfoes_not Invoive.��certif€cate of ot�upancy or
final pawer retease, #he fees must b� paid prlor to permit Issuance. Ftir:thermore;if Pasco C�unty 1Nater/Sewer�lmpaat
fees are due,they�musk.be-pald prlor to permlt-issuance-!n accordance wtth appllcabte Pasco County ardlnances.
Cf,�NSTRUCTION 1.lEN L.AV{P(Cha�nter 713� F�ocid�St�ttut�s��ts a�rtend�d): if valuatian of wark Is�2,50q.00 ar more, 1
certify that I, the applicant, have been provided with a copy of khe "Flarida Construction� Lfen Law:Homeawner's
Protection Guide" prepared by the Florlda Depa�tment of Agricuttttre and Consumer Affairs. Ef the appllcant Is someone
nther tha�th�a"owner", I certliy that I have.obtained a copy of the abode.descrlbed dacurr�ent°and pramise In.good faith to
deliver it to the°owner"prioe to cornmencement;
�ANTRACTQR'S/t,�WNER'�A�F@AViT: i certify that atl fhe information in this application is accurate and that ali wark
will�be done in compliance with all applicable laws regulating construction, xoning and land development. Application fs
hereby made ta obtain .a permi# to do worlc.and Insfatla#lon as Indtc�ted.� °I ceetify that no work or instalia#ion nas
cammenced prior to issuance af a permit and that all work wil) be pertormed ta meet standards af all laws regulati'ng�
cons#ructian, Gounty and City codes, xoning regulations, and land development regalatlons-in the juclsdictEon. 1 al'so
certify that 1 understand thal the �egulations of other government agencies m�y�apply�to the intended work, and that it is
my respansib(lity to identify�whak acti�ns I must take to bezin:.cot�tlpllance: S.uch agencles include but are.not llmftec!to:
- Department of ��tvironmental Protection-Cypress.Bayheads, Wetland Areas and Environmenta#ly Sensitive
Lands, WaterM/astewater Treatment.
- Southwest Florida Water Management Dfs#rlct We1is, Cypress. Bay_heads; Wetland Areas, Alter�ng
Watercaurses.
- Army Corps of Engineers-SeawaAs, Docks, Navigable Watennrays.
- Department af Heal#h 8 Rehabllitative Senrfces/Envitanmental Health Unit Well.s, Wastewater Treatmen#,
Septic Tanks. ,
- US Environmental Protectlon Agency-Asbesta�abaEemen4.
- Fede►�al Avlatlan Authority-Runways.
!understand that the foilowin�.restrlctlons apply to the use of fllP;•
- Use of fill is not allowed in Fiood 2one"V°unless eicpressly permi#ted.
- If the fiil material is to be used ln �Flood Zone "A", it. (s understoad that a drainage plan addressing a
"compensating valume" will be subml#ted a#t�me af permltting which is prepared by a prafess3anal engineer
I(censed by the State of Flarlda:
- !f the fili maferEal is to be used In flood �one °A° in�connectEon tn+�th.a��permitted buiid3ng using stem waH
canstruction, i certify that fiil�:wlll:b.e used only.to.fill the area within the stem watl.
- If till material Is to be used In any areat I certify that use af such fil! wil! not adversely affect ad�acent
prope�tles. tf use of fill ls found to adverseiy:�ffect adja�ent properties,.the owner may be cited for vio�ating
the condltions af the building:permit issued under the attached permit application, for lots less than one (1)
acr+e which ar�efevated by tlll,an engineer�ed dralnage plan is requlred. .
If 1 am the AG�NT FOR TNE OWNER, I;:promise In good faith#o inform the owner af-the permit#ing conditlans set forth In
this a�davlt�prlor tc� comrnencing construction. ! understa�d that a sepaeate permil may bs requlred for electrlcal work,
plumbing, signs, we0s, paoris; alr canditioning, .gas, or ather installations not,spec�ficaily included�in.fhe ap�lication. .A
permit issued shall be construed to b�a Itcense to proceed v�ith the work and not as.authority to.vialate, ca�cel, alter, or
seE aslde�ny provlslons c►f the technlc�l codes; nor shall tssuaotce�of a.permlt.pcevent the Bulldttig O#fllclal fram th�reafter
requlring a correction af�rrors In plans, construction or vicolatton�of any codes. Every permit issued shall become invalid
unless the v+rotk authorized.by such permft-�is-cornmenced�within stX manths of permlt lssuance, or if work authorized by
the permit is suspended or.abandoned for a period of six(8}months.after the time the woPk is commenced. An extensian
may be requested, in writing, from the Building.Official far a period not to exceed ninety(90) days and will demanstrate
�usti�able c�use for.the extension: If woric ceases far nlne#y(94}consecutive day.st..the�ob is considered a6ando�ed.
IAfARNiNG Tt? Q1fVN�R: 1l4Uit.FAQLURE�TO.R�GQRQ A NOTIG� t?F-CQMMENGEMEt�tT �IIAY RESt!!T 1N Y4UR
6�AYING TWiCE.POFt IMPROVEN4EN.'TS TO YOUR.PROPERTY. IF YO.t1�INTEI�ID�°TO�OBTAIN��Ild�ANC1NG�'CONSUI�7 � _
W17H YUUR i.ENDE�O AN _TTORN . -�ElFA��- ��S)��F� ��Y��l�'-R:� �'^ '62��"'�' E �i� � � --
Fl.OFtID�dUFtA�'{F.S.11 . ) -
DVNNER OR A(3EN'� CONTRACTO
5abscribed and swam or aftircned}before #hEs Subscrlbed and'svvom#o{ar a83rmed)�be t�a Is
by `
JVho Islare personally knobm lo me or haslhave produced Who Is/ar ersonally wn to ma or has/have produced
as IdenU�ca�on. as tdenti�cation.
. /,. � �
Notery PubUc / � ' � l,�-�-!';� ; //�,�'�•�. Plotary Public
:ommisslonNo. Comm st .No,!...-j
� .'.;a�"�G,�'�,, JACQUELINE BOGES
Vame ef No[ary typed�Printed or stamged Name of NotarY t1+P$�,���Lk��R$mber 12�?_�1II
't�;;:`��` Bondnd Tlw Troy fsin Insurnnsp kt��7115•9G19
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